Abstract
Introduction: Non-Ophthalmic medical doctors are more often than not the first to be consulted by patients with visual symptoms in health facilities due to scarcity of ophthalmologists. Studies have shown that patients present quite late to the ophthalmologist, when their vision may have been markedly impaired.
This study therefore aimed to assess the level of practice of the non-ophthalmic doctors on the prevalent eyes diseases causing avoidable blindness.
Materials and Method: A total of three-hundred-and-ninety-one, (391), non-ophthalmic medical doctors took part in the study. Owing to the fact that majority of the doctors work in the tertiary institutions while a few were located in the primary and secondary sectors, all the consenting doctors in the primary and secondary institutions were interviewed, whilst those from the tertiary centres were selected by a simple random process. The participants were examined through a pre-tested questionnaire on the definition, symptoms, causes and treatment of cataract, glaucoma, and refractive error. They were also assessed on their practice regarding ocular examination, referral of such cases when necessary as well as determining eye structures they assessed in cases of cataract, glaucoma, and refractive errors.
Results: The participants were 391: 313 males and 78 females. Twenty six of the respondents did not indicate their age. Majority of the participants (176; 45.0%) were aged 35.9±7.7 SD years and married (244; 62.4%). All the participants were Christians except one. The respondents had an overall mean score of 46.9% of their practice pattern. Place of work was the only statistically significant variable amongst others.
Conclusion: The respondents had poor practice pattern of prevalent blinding conditions like cataract, glaucoma and refractive errors. Exposure to ophthalmology during medical school training needs to be strengthened and encouraging practicing non-ophthalmic doctors to seek basic ophthalmic knowledge in the way of continuing medical education can help bridge the practice gap.
Keywords: Practices, Non-Ophthalmic, Doctors, Eye, Diseases.
References
- Coleman AL, Gergana K, Walace SP, Michael P, Ortega AN, Giarconi J. Visual functioning of individuals and communities. Clinical medicine: Geriatrics. 2008; 2:13-20.
- Eze BI, Oguego NC, Uche JN, Mbah CN. Assessing the knowledge and skills in clinical ophthalmology of medical interns: survey results from Enugu South- Eastern Nigeria. http/www.meajo.org.IP:41 203.64.128.
- Wilson A, Coll JR. The red eye: a general practice survey. Gen Pract.1987; 37:62-4.
- Harrison RJ, Wild JM, Hobley AJ. Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease. BMJ. 1988; 297: 1162-7.
- Brittain GP, Austin DJ. A prospective study to determine sources and diagnostic accuracy of glaucoma referrals. Health Trends. 1988; 20:43-4.
- MacKean JM, Elkington AR. Referral routes to hospital of patients with chronic open angle glaucoma. BMJ 1982; 285:1093-5.
- Lavin MJ, Rose GE. Use of steroid drops in general practice. BMJ. 1986; 292: 1448-50.
- Claoue CM, Stevenson KE. Incidence of inappropriate treatment of herpes simplex keratitis with steroids. BMJ. 1986; 292:1450-1.
- Jones NP, Lloyd IC, Kwartz J. General practitioner referrals to an eye hospital: a standard referral letter. R Soc Med. 1990; 83:770-2.
- Thylefors B. The World Health Organisation’s programme for the prevention of blindness. Int Ophthalmol. 1990; 14:211-219.
- Geoffery T, Chen M, Espander L. Current opinion in ophthalmol. 2008; 19:55-59.
- Resnikoff S, Parcolini D, Etya’ale D. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004; 82: 844-851.
- Frick KD, Foster A. The magnitude and cost of global blindness: an increasing problem that can be alleviated. Am J Ophthalmol. 2003; 135:471-476.
- Sastry SM, Chyang YP, Javitt JC. Practice patterns of the office-based ophthalmologist. Ophthalmic surg. 1994; 25: 76-81.
- Quigley HA. Number of people with glaucoma world-wide. Br J Ophthalmol. 1996; 80: 389-393.
- Abdul MM, Sivasubramanians NG, Gilbert C, Abubakar T, Ezelum C, Rabiu MM. Nigerian National Blindness and Visual Impairment Study group. Causes of blindness and visual impairment in Nigeria: The Nigerian blindness and visual impairment survey. Invest ophthalmol vis sci 2009; 50(9):4114-4120.
- Resnikoff F, Donatella P, Silvio PM. Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ. 2008; 86:63-70.
- Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1994; 35:4344-4347.
- Health Products Research, Inc., Vision Information Services -The Contact Lens Report.2002.
- Sperduto RD, Roberts J, Rowland M. Prevalence of myopia in the United States. Arch Ophthalmol. 1983; 101:405-407.
- Eze BI, Maduka-Okafor FC. An assessment of the eye care workforce in Enugu State, South-eastern Nigeria. Human Resources for Health.2009, 7:38.
- Daghio MM, Ciardullo AV, Cadioli T, Delvecchio C, Menna A, Voci C, et al. GPs’ satisfaction with the doctor–patient encounter: findings from a community based survey. Family Practice. 2003; 20: 283–288.
- Mahmoud AO. Primary eye care delivery in a rural community in Northern Nigeria. Dissertation submitted to the National Postgraduate Medical College of Nigeria Lagos. 1993 page 4.
- Akinsola FB, Alimi HL Oyele TO and Majekodumi AA. Knowledge, Attitude and Practice of Eye Health Care amongst doctors in Lagos. Nigerian Quaterly Journal of Hospital Medicine. Vol. 14,1;12:31-34.
- Stern GA. Teaching ophthalmology to primary care physicians. The Association of University Professors of Ophthalmology Education Committee. Arch Ophthalmol. 1995; 113:722–724.
- Daghio MM, Ciardullo AV, Cadioli T, Delvecchio C, Menna A, Voci C, et al. GPs’ satisfaction with the doctor–patient encounter: findings from a community based survey. Family Practice. 2003; 20: 283–288.
- Pierscionek TJ, Moore JE, Pierscionek BK. Referrals to ophthalmology: optometric and general practice comparison. Ophthalmic Physiol Opt. 2009; Jan; 29(1):32–40.
- Jackson C, Hirst L. Brisbane GPs’ perceptions of screening for primary open angle glaucoma. Aust N Z J Ophthalmol. 1995 Aug; 23(3):179–81.
- Khanderkar R, Shar S, Al lawatti J. Retinal examination of diabetic patients: knowledge, attitude and practices of physicians. Eastern Mediterrenian Health Journal. 2008; 14:4.
Corresponding Author
Nkiruka N.M Okoloagu
Department of Ophthalmology, College of Medicine, Enugu State University of Science and Technology Enugu, Nigeria
DOI: https://dx.doi.org/10.18535/jmscr/v9i1.27
